Privacy Act of 1974; Report of a New System of Records, 45397-45401 [05-15165]
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Federal Register / Vol. 70, No. 150 / Friday, August 5, 2005 / Notices
preference about medical treatment. The
individual may make his preference
known through the use of an advance
directive, which is a written instruction
prepared in advance, such as a living
will or durable power of attorney. This
information is documented in a
prominent part of the individual’s
medical record. Advance directives as
described in the Patient SelfDetermination Act (enacted in 1991)
have increased the individual’s control
over decisions concerning medical
treatment. The advance directives
requirement was enacted because
Congress wanted individuals to know
that they have a right to make health
care decisions and to refuse treatment
even when they are unable to
communicate.; Frequency: On occasion;
Affected Public: Business or other forprofit; Number of Respondents: 33,096;
Total Annual Responses: 33,096; Total
Annual Hours: 924,120.
6. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Payment
Adjustment for Sole Community
Hospitals and Supporting Regulations in
42 CFR Section 412.92; Form No.: CMS–
R–79 (OMB# 0938–0477); Use: This
collection provides that if a hospital that
is classified as a sole community
hospital (SCH) experiences, due to
circumstances beyond its control, a
decrease of more than 5 percent in its
total number of discharges compared to
the immediately preceding cost
reporting period, the hospital may apply
for a payment adjustment. To qualify for
this adjustment to its payment rate an
SCH must submit documentation,
including cost information as requested
by CMS, to the intermediary; Frequency:
On occasion; Affected Public: Not-forprofit institutions, Business or other forprofit, and State, Local or Tribal
Government; Number of Respondents:
40; Total Annual Responses: 40; Total
Annual Hours: 160.
To obtain copies of the supporting
statement and any related forms for
these paperwork collections referenced
above, access CMS Web site address at
https://www.cms.hhs.gov/regulations/
pra/, or e-mail your request, including
your address, phone number, OMB
number, and CMS document identifier,
to Paperwork@cms.hhs.gov, or call the
Reports Clearance Office on (410) 786–
1326.
Written comments and
recommendations for these information
collections will be considered if they are
mailed within 30 days of this notice
directly to the OMB desk officer: OMB
Human Resources and Housing Branch,
Attention: Christopher Martin, New
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Executive Office Building, Room 10235,
Washington, DC 20503.
Dated: July 29, 2005.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. 05–15505 Filed 8–4–05; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
Privacy Act of 1974; Report of a New
System of Records
Department of Health and
Human Services (HHS), Centers for
Medicare & Medicaid Services (CMS).
ACTION: Notice of a New System of
Records.
AGENCY:
SUMMARY: In accordance with the
requirements of the Privacy Act of 1974,
we are proposing to establish a new
system titled ‘‘Federal Reimbursement
of Emergency Health Services Furnished
to Undocumented Aliens (Section
1011),’’ System No. 09–07–0546. The
system will contain enrollment and
payment request information, in support
of a short-term program which pays
hospitals, certain physicians, and
ambulance providers (including Indian
Health Service (IHS) facilities whether
operated by the IHS or by an Indian
Tribe or tribal organization) for their
otherwise un-reimbursed costs of
services provided under the provisions
of section 1867 (Emergency Medical
Treatment and Labor Act) (EMTALA) of
the Social Security Act (the Act) and
related hospital inpatient and outpatient
services and ambulance services
furnished to undocumented aliens,
aliens paroled into the United States
(U.S.) at a U. S. port of entry for the
purposes of receiving such services, and
Mexican citizens permitted temporary
entry to the U.S. for not more than 30
days under the authority of a biometric
machine readable border crossing
identification card (also referred to as a
‘‘laser visa’’) issued in accordance with
the requirements of regulations
prescribed under the Immigration and
Nationality Act. This system is being
established under provisions of Section
1011 of the Medicare Prescription Drug,
Improvement and Modernization Act of
2003 Modernization Act of 2003
(MMA).
The primary purpose of the system is
to maintain information collected on
individuals who submit an enrollment
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45397
application and make payment requests
associated with Section 1011 of the
MMA, and other information designed
to support the enrollment, claims
payment, and research reporting
functions of the Section 1011 program.
Information retrieved from this system
will also be disclosed to: (1) Support
regulatory, payment activities, and
policy functions performed within the
agency or by a designated contractor or
consultant; (2) combat fraud and abuse
in certain health benefits programs; (3)
assist another Federal or state agency
with information to enable such agency
to administer a Federal health benefits
program, or to enable such agency to
fulfill a requirement of a Federal statute
or regulation that implements a health
benefits program funded in whole or in
part with Federal; (4) funds support
constituent requests made to a
Congressional representative; and, (5)
support litigation involving the agency.
We have provided background
information about the new system in the
SUPPLEMENTARY INFORMATION section
below. Although the Privacy Act
requires only that the ‘‘routine use’’
portion of the system be published for
comment, CMS invites comments on all
portions of this notice. See DATES
section for comment period.
DATES: CMS filed a new system report
with the Chair of the House Committee
on Government Reform and Oversight,
the Chair of the Senate Committee on
Governmental Affairs, and the
Administrator, Office of Information
and Regulatory Affairs, Office of
Management and Budget (OMB) on July
21, 2005. In any event, we will not
disclose any information under a
routine use until 40 days after
publication. We may defer
implementation of this system or one or
more of the routine use statements listed
below if we receive comments that
persuade us to defer implementation.
ADDRESSES: The public should address
comments to: CMS Privacy Officer,
Division of Privacy Compliance Data
Development (DPCDD), CMS, Mail Stop
N2–04–27, 7500 Security Boulevard,
Baltimore, Maryland 21244–1850.
Comments received will be available for
review at this location, by appointment,
during regular business hours, Monday
through Friday from 9 a.m.–3 p.m.,
eastern time zone.
FOR FURTHER INFORMATION CONTACT:
Section 1011 Project Officer, Center for
Medicare Management, CMS, Mailstop
C4–10–07, 7500 Security Boulevard,
Baltimore, Maryland 21244–1850.
SUPPLEMENTARY INFORMATION: Sections
1866(a)(1)(I), 1866(a)(1)(N), and 1867 of
the Act impose specific obligations on
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Medicare-participating hospitals that
offer emergency services. These
obligations concern individuals who
come to a hospital emergency
department and request examination or
treatment for medical conditions, and
apply to all of these individuals,
regardless of whether or not they are
beneficiaries of any program under the
Act. Section 1867 of the Act sets forth
requirements for medical screening
examinations of medical conditions, as
well as necessary stabilizing treatment
or appropriate transfer. In addition,
section 1867(h) of the Act specifically
prohibits a delay in providing required
screening or stabilization services in
order to inquire about the individual’s
payment method or insurance status.
Section 1867(d) of the Act provides for
the imposition of civil monetary
penalties on hospitals responsible for
negligently violating a requirement of
that section, through actions such as the
following: (a) Negligently failing to
appropriately screen an individual
seeking medical care; (b) negligently
failing to provide stabilizing treatment
to an individual with an emergency
medical condition; or (c) negligently
transferring an individual in an
inappropriate manner. (Section
1867(e)(4) of the Act defines ‘‘transfer’’
to include both transfers to other health
care facilities and cases in which the
individual is released from the care of
the hospital without being moved to
another health care facility.)
These provisions, taken together, are
frequently referred to as the Emergency
Medical Treatment and Labor Act
(EMTALA), also known as the patient
antidumping statute. EMTALA was
passed in 1986 as part of the
Consolidated Omnibus Budget
Reconciliation Act of 1985 (COBRA).
Congress enacted these antidumping
provisions in the Act because of its
concern with an increasing number of
reports that hospital emergency rooms
were refusing to accept or treat
individuals with emergency conditions
if the individuals did not have
insurance.
I. Description of the New System of
Records
A. Statutory and Regulatory Basis for
System
The authority to conduct the program
is given under the provisions of Section
1011 of the Medicare Prescription Drug,
Improvement and Modernization Act of
2003 (Pub. L. 108–173).
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B. Collection and Maintenance of Data
in the System
The Section 1011 program includes
the provider name and identification
number, provider address, provider
employer identification number,
provider banking information, provider
federal tax identification number,
patient’s control number, medical
record number, date of service, patient’s
gender, zip code, state and county, the
principle diagnosis code, admitting
diagnosis code, and total charges. It also
includes claims information related to
Section 1011 payment requests, and
other research information needed to
pay claims and administer the Section
1011 program.
II. Agency Policies, Procedures, and
Restrictions on the Routine
The Privacy Act permits us to disclose
information without an individual’s
consent if the information is to be used
for a purpose that is compatible with the
purpose(s) for which the information
was collected. Any such disclosure of
data is known as a ‘‘routine use.’’ The
government will only release Section
1011 program information that can be
associated with an individual provider
as provided for under ‘‘Section III.
Entities Who May Receive Disclosures
under Routine Use.’’ Both identifiable
and non-identifiable data may be
disclosed under a routine use.
Identifiable data includes individual
records with Section 1011 program
information and identifiers. Nonidentifiable data includes individual
records with Section 1011 program
information and masked identifiers or
Section 1011 program information with
identifiers stripped out of the file.
We will only disclose the minimum
personal data necessary to achieve the
purpose of the Section 1011 program.
CMS has the following policies and
procedures concerning disclosures of
information that will be maintained in
the system. In general, disclosure of
information from the system will be
approved only for the minimum
information necessary to accomplish the
purpose of the disclosure after CMS:
1. Determines that the use or
disclosure is consistent with the reason
that the data is being collected; e.g., to
maintain information needed when
submitting an enrollment application
and make payment requests associated
with Section 1011(a) of the MMA;.
2. Determines that:
a. The purpose for which the
disclosure is to be made can only be
accomplished if
b. The record is provided in
individually identifiable form;
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c. The purpose for which the
disclosure is to be made is of sufficient
importance to warrant the effect and/or
risk on the privacy of the individual that
additional exposure of the record might
bring; and
d. There is a strong probability that
the proposed use of the data would in
fact accomplish the stated purpose(s).
3. Requires the information recipient
to:
a. Establish administrative, technical,
and physical safeguards to prevent
unauthorized use of disclosure of the
record;
b. Remove or destroy at the earliest
time all patient-identifiable information;
and
c. Agree to not use or disclose the
information for any purpose other than
the stated purpose under which the
information was disclosed.
4. Determines that the data are valid
and reliable.
III. Proposed Routine Use Disclosures
of Data in the System
A. Entities Who May Receive
Disclosures Under Routine Use
These routine uses specify
circumstances, in addition to those
provided by statute in the Privacy Act
of 1974, under which CMS may release
information from the Section 1011
program without the consent of the
individual to whom such information
pertains. Each proposed disclosure of
information under these routine uses
will be evaluated to ensure that the
disclosure is legally permissible,
including but not limited to ensuring
that the purpose of the disclosure is
compatible with the purpose for which
the information was collected. We are
proposing to establish the following
routine use disclosures of information
maintained in the system:
1. To agency contractors or
consultants who have been contracted
by the agency to assist in the
performance of a service related to this
system and who need to have access to
the records in order to perform the
activity.
We contemplate disclosing
information under this routine use only
in situations in which CMS may enter
into a contractual or similar agreement
with a third party to assist in
accomplishing agency business
functions relating to purposes for this
system of records.
CMS occasionally contracts out
certain of its functions when doing so
would contribute to effective and
efficient operations. CMS must be able
to give a contractor whatever
information is necessary for the
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contractor to fulfill its duties. In these
situations, safeguards are provided in
the contract prohibiting the contractor
from using or disclosing the information
for any purpose other than that
described in the contract and requires
the contractor to return or destroy all
information at the completion of the
contract.
2. To a CMS contractor that assists in
the administration of a CMSadministered health benefits program,
when disclosure is deemed reasonably
necessary by CMS to prevent, deter,
discover, detect, investigate, examine,
prosecute, sue with respect to, defend
against, correct, remedy, or otherwise
combat fraud or abuse in such program.
We contemplate disclosing
information under this routine use only
in situations in which CMS may enter
into a contractual relationship or grant
with a third party to assist in
accomplishing CMS functions relating
to the purpose of combating fraud and
abuse.
CMS occasionally contracts out
certain of its functions and makes grants
when doing so would contribute to
effective and efficient operations. CMS
must be able to give a contractor or
grantee whatever information is
necessary for the contractor or grantee to
fulfill its duties. In these situations,
safeguards are provided in the contract
prohibiting the contractor or grantee
from using or disclosing the information
for any purpose other than that
described in the contract and requiring
the contractor or grantee to return or
destroy all information.
3. To another Federal agency or to an
instrumentality of any governmental
jurisdiction within or under the control
of the United States (including any State
or local governmental agency), that
administers, or that has the authority to
investigate potential fraud or abuse in,
a health benefits program funded in
whole or in part by Federal funds, when
disclosure is deemed reasonably
necessary by CMS to prevent, deter,
discover, detect, investigate, examine,
prosecute, sue with respect to, defend
against, correct, remedy, or otherwise
combat fraud or abuse in such programs.
Other agencies may require Section
1011 program information for the
purpose of combating fraud and abuse
in such Federally-funded programs.
Releases of information would be
allowed if the proposed use(s) for the
information proved compatible with the
purposes of collecting the information.
4. To another Federal or state agency
to:
a. Contribute to the accuracy of CMS’’
proper payment of a health benefit, or
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b. Enable such agency to administer a
Federal health benefits program, or as
necessary to enable such agency to
fulfill a requirement of a Federal statute
or regulation that implements a health
benefits program funded in whole or in
part with Federal funds.
Other Federal or state agencies in
their administration of a Federal health
program may require Section 1011
program information in order to ensure
that proper payment for services were
provided. Releases of information
would be allowed if the proposed use(s)
for the information proved compatible
with the purpose for which CMS
collects the information.
5. To a Member of Congress or to a
congressional staff member in response
to an inquiry of the Congressional Office
made at the written request of the
constituent about whom the record is
maintained.
Individuals sometimes request the
help of a Member of Congress in
resolving some issue relating to a matter
before CMS. The Member of Congress
then writes CMS, and CMS must be able
to give sufficient information to be
responsive to the inquiry.
6. To the Department of Justice (DOJ),
court or adjudicatory body when:
a. The agency or any component
thereof, or
b. Any employee of the agency in his
or her official capacity; or
c. Any employee of the agency in his
or her individual capacity where the
DOJ has agreed to represent the
employee, or
d. The United States Government;
Is a party to litigation or has an
interest in such litigation, and by careful
review, CMS determines that the
records are both relevant and necessary
to the litigation.
Whenever CMS is involved in
litigation, or occasionally when another
party is involved in litigation and CMS’
policies or operations could be affected
by the outcome of the litigation, CMS
would be able to disclose information to
the DOJ, court or adjudicatory body
involved. A determination would be
made in each instance that, under the
circumstances involved, the purposes
served by the use of the information in
the particular litigation is compatible
with a purpose for which CMS collects
the information.
B. Additional Provisions Affecting
Routine Use Disclosures
This system contains Protected Health
Information (PHI) as defined by HHS
regulation ‘‘Standards for Privacy of
Individually Identifiable Health
Information’’ (45 CFR parts 160 and 164,
65 FR 82462 (12–28–00), Subparts A
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45399
and E. Disclosures of PHI authorized by
these routine uses may only be made if,
and as, permitted or required by the
‘‘Standards for Privacy of Individually
Identifiable Health Information.’’
In addition, our policy will be to
prohibit release even of not directly
identifiable, except pursuant to one of
the routine uses or if required by law,
if we determine there is a possibility
that an individual can be identified
through implicit deduction based on
small cell sizes (instances where the
patient population is so small that
individuals who are familiar with the
enrollees could, because of the small
size, use this information to deduce the
identity of the beneficiary).
IV. Safeguards
CMS has safeguards in place for
authorized users and monitors such
users to ensure against excessive or
unauthorized use. Personnel having
access to the system have been trained
in the Privacy Act and information
security requirements. Employees who
maintain records in this system are
instructed not to release data until the
intended recipient agrees to implement
appropriate management, operational
and technical safeguards sufficient to
protect the confidentiality, integrity and
availability of the information and
information systems and to prevent
unauthorized access.
This system will conform to all
applicable Federal laws and regulations
and Federal, HHS, and CMS policies
and standards as they relate to
information security and data privacy.
These laws and regulations include but
are not limited to: the Privacy Act of
1974; the Federal Information Security
Management Act of 2002; the Computer
Fraud and Abuse Act of 1986; the
Health Insurance Portability and
Accountability Act of 1996; the EGovernment Act of 2002, the ClingerCohen Act of 1996; the Medicare
Modernization Act of 2003, and the
corresponding implementing
regulations. OMB Circular A–130,
Management of Federal Resources,
Appendix III, Security of Federal
Automated Information Resources also
applies. Federal, HHS, and CMS
policies and standards include but are
not limited to: All pertinent NIST
publications; the HHS Information
Systems Program Handbook and the
CMS Information Security Handbook.
V. Effects of the New System on
Individual Rights
CMS proposes to establish this system
in accordance with the principles and
requirements of the Privacy Act and will
collect, use, and disseminate
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information only as prescribed therein.
Data in this system will be subject to the
authorized releases in accordance with
the routine uses identified in this
system of records.
CMS will monitor the collection and
reporting of Section 1011 data. Section
1011 information on patients is
submitted to CMS in a standard
payment system. Accuracy of the data is
important since incorrect information
could result in the wrong payment for
services. CMS will utilize a variety of
onsite and offsite edits and audits to
increase the accuracy of Section 1011
payment requests.
CMS will take precautionary
measures (see item IV. above) to
minimize the risks of unauthorized
access to the records and the potential
harm to individual privacy or other
personal or property rights of patients
whose data is maintained in the system.
CMS will collect only that information
necessary to perform the system’s
functions. In addition, CMS will make
disclosure from the proposed system
only with consent of the subject
individual, or his/her legal
representative, or in accordance with an
applicable exception provision of the
Privacy Act.
CMS, therefore, does not anticipate an
unfavorable effect on individual privacy
as a result of maintaining this system of
records.
Charlene Brown,
Chief Operating Officer, Centers for Medicare
& Medicaid Services.
SYSTEM NO. 09–70–0546
SYSTEM NAME:
‘‘Federal Reimbursement of
Emergency Health Services Furnished to
Undocumented Aliens (Section 1011)’’
HHS/CMS/CMM.
SECURITY CLASSIFICATION:
Level 3, Privacy Act Sensitive.
SYSTEM LOCATION:
CMS Data Center, 7500 Security
Boulevard, North Building, First Floor,
Baltimore, Maryland 21244–1850 and
CMS contractors and agents at various
locations.
CATEGORIES OF INDIVIDUALS COVERED BY THE
SYSTEM:
The Section 1011 program will
include information on individuals who
have elected to participate in the
Section 1011 program, claims
information related to Section 1011
payment requests, and information
needed to pay claims and administer the
Section 1011 program.
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CATEGORIES OF RECORDS IN THE SYSTEM:
The Section 1011 program includes
the provider name and identification
number, provider address, provider
employer identification number,
provider banking information, provider
Federal tax identification number,
patient’s control number, medical
record number, date of service, patient’s
gender, zip code, state and county, the
principle diagnosis code, admitting
diagnosis code, and total charges. It also
includes claims information related to
Section 1011 payment requests, and
other research information needed to
pay claims and administer the Section
1011 program.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
The authority to conduct the program
is given under the provisions of Section
1011 of the Medicare Prescription Drug,
Improvement and Modernization Act of
2003 (Pub. L. 108–173).
PURPOSE (S) OF THE SYSTEM:
The primary purpose of the system is
to maintain information collected on
individuals who submit an enrollment
application and make payment requests
associated with Section 1011 of the
MMA, and other information designed
to support the enrollment, claims
payment, and research reporting
functions of the Section 1011 program.
Information retrieved from this system
will also be disclosed to: (1) Support
regulatory, payment activities, and
policy functions performed within the
agency or by a designated contractor or
consultant; (2) combat fraud and abuse
in certain health benefits programs; (3)
assist another Federal or state agency
with information to enable such agency
to administer a Federal health benefits
program, or to enable such agency to
fulfill a requirement of a Federal statute
or regulation that implements a health
benefits program funded in whole or in
part with Federal; (4) funds support
constituent requests made to a
Congressional representative; and, (5)
support litigation involving the agency.
ROUTINE USES OF RECORDS MAINTAINED IN THE
SYSTEM, INCLUDING CATEGORIES OR USERS AND
THE PURPOSES OF SUCH USES:
A. Entities Who May Receive
Disclosures Under Routine Use
These routine uses specify
circumstances, in addition to those
provided by statute in the Privacy Act
of 1974, under which CMS may release
information from the Section 1011
program without the consent of the
individual to whom such information
pertains. Each proposed disclosure of
information under these routine uses
will be evaluated to ensure that the
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disclosure is legally permissible,
including but not limited to ensuring
that the purpose of the disclosure is
compatible with the purpose for which
the information was collected. We are
proposing to establish the following
routine use disclosures of information
maintained in the system:
1. To agency contractors or
consultants who have been contracted
by the agency to assist in the
performance of a service related to this
system and who need to have access to
the records in order to perform the
activity.
2. To a CMS contractor that assists in
the administration of a CMSadministered health benefits program,
or to a grantee of a CMS-administered
grant program, when disclosure is
deemed reasonably necessary by CMS to
prevent, deter, discover, detect,
investigate, examine, prosecute, sue
with respect to, defend against, correct,
remedy, or otherwise combat fraud or
abuse in such program.
3. To another Federal agency or to an
instrumentality of any governmental
jurisdiction within or under the control
of the United States (including any State
or local governmental agency), that
administers, or that has the authority to
investigate potential fraud or abuse in,
a health benefits program funded in
whole or in part by Federal funds, when
disclosure is deemed reasonably
necessary by CMS to prevent, deter,
discover, detect, investigate, examine,
prosecute, sue with respect to, defend
against, correct, remedy, or otherwise
combat fraud or abuse in such programs.
4. To another Federal or State agency
to:
a. Contribute to the accuracy of CMS’
proper payment of a health benefit, or
b. Enable such agency to administer a
Federal health benefits program, or as
necessary to enable such agency to
fulfill a requirement of a Federal statute
or regulation that implements a health
benefits program funded in whole or in
part with Federal funds.
5. To a Member of Congress or to a
congressional staff member in response
to an inquiry of the Congressional Office
made at the written request of the
constituent about whom the record is
maintained.
6. To the Department of Justice (DOJ),
court or adjudicatory body when:
a. The agency or any component
thereof, or
b. Any employee of the agency in his
or her official capacity; or
c. Any employee of the agency in his
or her individual capacity where the
DOJ has agreed to represent the
employee, or
d. The United States Government;
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Is a party to litigation or has an
interest in such litigation, and by careful
review, CMS determines that the
records are both relevant and necessary
to the litigation.
B. Additional Provisions Affecting
Routine Use Disclosures
This system contains Protected Health
Information (PHI) as defined by HHS
regulation ‘‘Standards for Privacy of
Individually Identifiable Health
Information’’ (45 CFR parts 160 and 164,
65 FR 82462 (12–28–00), Subparts A
and E. Disclosures of PHI authorized by
these routine uses may only be made if,
and as, permitted or required by the
‘‘Standards for Privacy of Individually
Identifiable Health Information.’’
In addition, our policy will be to
prohibit release even of not directly
identifiable, except pursuant to one of
the routine uses or if required by law,
if we determine there is a possibility
that an individual can be identified
through implicit deduction based on
small cell sizes (instances where the
patient population is so small that
individuals who are familiar with the
enrollees could, because of the small
size, use this information to deduce the
identity of the beneficiary).
POLICIES AND PRACTICES FOR STORING,
RETRIEVING, ACCESSING, RETAINING, AND
DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
Providers will retrieve medical
records by the patient control number.
Provider IDs and patient control
numbers are used to facilitate inquiries
into specific claims as needed.
SAFEGUARDS:
CMS has safeguards in place for
authorized users and monitors such
users to ensure against excessive or
unauthorized use. Personnel having
access to the system have been trained
in the Privacy Act and information
security requirements. Employees who
maintain records in this system are
instructed not to release data until the
intended recipient agrees to implement
appropriate management, operational
and technical safeguards sufficient to
protect the confidentiality, integrity and
availability of the information and
information systems and to prevent
unauthorized access.
This system will conform to all
applicable Federal laws and regulations
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CMS will retain identifiable Section
1011 data for an indefinite period. Data
residing with the designated claims
payment contractor shall be returned to
CMS at the end of the fifth program
year, with all data then being the
responsibility of CMS for adequate
storage and security.
Section 1011 Project Officer, Center
for Medicare Management, CMS, 7500
Security Boulevard, Mail Stop C4–10–
07, Baltimore, Maryland, 21244–1850.
RETRIEVABILITY:
15:34 Aug 04, 2005
RETENTION AND DISPOSAL:
SYSTEM MANAGER AND ADDRESS:
All claim records are stored on
magnetic media. Patient eligibility
information may be maintained
electronically or in paper format.
VerDate jul<14>2003
and Federal, HHS, and CMS policies
and standards as they relate to
information security and data privacy.
These laws and regulations include but
are not limited to: The Privacy Act of
1974; the Federal Information Security
Management Act of 2002; the Computer
Fraud and Abuse Act of 1986; the
Health Insurance Portability and
Accountability Act of 1996; the EGovernment Act of 2002, the ClingerCohen Act of 1996; the Medicare
Modernization Act of 2003, and the
corresponding implementing
regulations. OMB Circular A–130,
Management of Federal Resources,
Appendix III, Security of Federal
Automated Information Resources also
applies. Federal, HHS, and CMS
policies and standards include but are
not limited to: All pertinent NIST
publications; the HHS Automated
Information Systems Security Handbook
and the CMS Information Security
Handbook.
NOTIFICATION PROCEDURE:
For purpose of access, the subject
individual should write to the system
manager who will require the system
name, and for verification purposes, the
subject individual’s name and provider
identification number and the patient’s
medical record number.
RECORD ACCESS PROCEDURE:
For purpose of access, use the same
procedures outlined in Notification
Procedures above. Requestors should
also reasonably specify the record
contents being sought. (These
procedures are in accordance with
Department regulation 45 CFR
5b.5(a)(2).)
CONTESTING RECORD PROCEDURES:
The subject individual should contact
the system manager named above, and
reasonably identify the record and
specify the information to be contested.
State the corrective action sought and
the reasons for the correction with
PO 00000
Frm 00049
Fmt 4703
Sfmt 4703
45401
supporting justification. (These
procedures are in accordance with
Department regulation 45 CFR 5b.7.)
RECORD SOURCE CATEGORIES:
Information maintained in this system
will be collected from individuals
volunteering to participate in Section
1011 program through the enrollment
application and claims data requesting
payment for services.
SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS
OF THE ACT:
None.
[FR Doc. 05–15165 Filed 8–4–05; 8:45 am]
BILLING CODE 4120–03–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Proposed Information Collection
Activity; Comment Request
Proposed Projects
Title: Compassion Capital Fund
Evaluation—Initial Outcome Study.
OMB No.: New collection.
Description: This proposed
information collection activity is for an
initial outcome study that is one
component of the evaluation of the
Compassion Capital Fund (CCF)
program. The information collection
will be through mailed surveys to be
completed by selected faith-based and
community organizations that received
sub-awards from CCF grantees. The CCF
grantees are intermediary organizations
that provide capacity building services
to faith-based and community
organizations.
The CCF evaluation is an important
opportunity to examine the outcomes
and effectiveness of the Compassion
Capital Fund in meeting its objective of
improving the capacity of faith-based
and community organizations. This
initial outcome study component of the
evaluation will involve approximately
180 faith-based and community
organizations. Information will be
sought from these organizations to
assess change and improvement in
various areas of capacity resulting from
receipt of sub-awards.
Respondents: The respondents will be
selected faith-based and community
organizations that received sub-awards
in 2003 from nine selected CCF
intermediary grantees. The surveys will
be self-administered.
E:\FR\FM\05AUN1.SGM
05AUN1
Agencies
[Federal Register Volume 70, Number 150 (Friday, August 5, 2005)]
[Notices]
[Pages 45397-45401]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-15165]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Privacy Act of 1974; Report of a New System of Records
AGENCY: Department of Health and Human Services (HHS), Centers for
Medicare & Medicaid Services (CMS).
ACTION: Notice of a New System of Records.
-----------------------------------------------------------------------
SUMMARY: In accordance with the requirements of the Privacy Act of
1974, we are proposing to establish a new system titled ``Federal
Reimbursement of Emergency Health Services Furnished to Undocumented
Aliens (Section 1011),'' System No. 09-07-0546. The system will contain
enrollment and payment request information, in support of a short-term
program which pays hospitals, certain physicians, and ambulance
providers (including Indian Health Service (IHS) facilities whether
operated by the IHS or by an Indian Tribe or tribal organization) for
their otherwise un-reimbursed costs of services provided under the
provisions of section 1867 (Emergency Medical Treatment and Labor Act)
(EMTALA) of the Social Security Act (the Act) and related hospital
inpatient and outpatient services and ambulance services furnished to
undocumented aliens, aliens paroled into the United States (U.S.) at a
U. S. port of entry for the purposes of receiving such services, and
Mexican citizens permitted temporary entry to the U.S. for not more
than 30 days under the authority of a biometric machine readable border
crossing identification card (also referred to as a ``laser visa'')
issued in accordance with the requirements of regulations prescribed
under the Immigration and Nationality Act. This system is being
established under provisions of Section 1011 of the Medicare
Prescription Drug, Improvement and Modernization Act of 2003
Modernization Act of 2003 (MMA).
The primary purpose of the system is to maintain information
collected on individuals who submit an enrollment application and make
payment requests associated with Section 1011 of the MMA, and other
information designed to support the enrollment, claims payment, and
research reporting functions of the Section 1011 program. Information
retrieved from this system will also be disclosed to: (1) Support
regulatory, payment activities, and policy functions performed within
the agency or by a designated contractor or consultant; (2) combat
fraud and abuse in certain health benefits programs; (3) assist another
Federal or state agency with information to enable such agency to
administer a Federal health benefits program, or to enable such agency
to fulfill a requirement of a Federal statute or regulation that
implements a health benefits program funded in whole or in part with
Federal; (4) funds support constituent requests made to a Congressional
representative; and, (5) support litigation involving the agency. We
have provided background information about the new system in the
SUPPLEMENTARY INFORMATION section below. Although the Privacy Act
requires only that the ``routine use'' portion of the system be
published for comment, CMS invites comments on all portions of this
notice. See DATES section for comment period.
DATES: CMS filed a new system report with the Chair of the House
Committee on Government Reform and Oversight, the Chair of the Senate
Committee on Governmental Affairs, and the Administrator, Office of
Information and Regulatory Affairs, Office of Management and Budget
(OMB) on July 21, 2005. In any event, we will not disclose any
information under a routine use until 40 days after publication. We may
defer implementation of this system or one or more of the routine use
statements listed below if we receive comments that persuade us to
defer implementation.
ADDRESSES: The public should address comments to: CMS Privacy Officer,
Division of Privacy Compliance Data Development (DPCDD), CMS, Mail Stop
N2-04-27, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.
Comments received will be available for review at this location, by
appointment, during regular business hours, Monday through Friday from
9 a.m.-3 p.m., eastern time zone.
FOR FURTHER INFORMATION CONTACT: Section 1011 Project Officer, Center
for Medicare Management, CMS, Mailstop C4-10-07, 7500 Security
Boulevard, Baltimore, Maryland 21244-1850.
SUPPLEMENTARY INFORMATION: Sections 1866(a)(1)(I), 1866(a)(1)(N), and
1867 of the Act impose specific obligations on
[[Page 45398]]
Medicare-participating hospitals that offer emergency services. These
obligations concern individuals who come to a hospital emergency
department and request examination or treatment for medical conditions,
and apply to all of these individuals, regardless of whether or not
they are beneficiaries of any program under the Act. Section 1867 of
the Act sets forth requirements for medical screening examinations of
medical conditions, as well as necessary stabilizing treatment or
appropriate transfer. In addition, section 1867(h) of the Act
specifically prohibits a delay in providing required screening or
stabilization services in order to inquire about the individual's
payment method or insurance status. Section 1867(d) of the Act provides
for the imposition of civil monetary penalties on hospitals responsible
for negligently violating a requirement of that section, through
actions such as the following: (a) Negligently failing to appropriately
screen an individual seeking medical care; (b) negligently failing to
provide stabilizing treatment to an individual with an emergency
medical condition; or (c) negligently transferring an individual in an
inappropriate manner. (Section 1867(e)(4) of the Act defines
``transfer'' to include both transfers to other health care facilities
and cases in which the individual is released from the care of the
hospital without being moved to another health care facility.)
These provisions, taken together, are frequently referred to as the
Emergency Medical Treatment and Labor Act (EMTALA), also known as the
patient antidumping statute. EMTALA was passed in 1986 as part of the
Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA).
Congress enacted these antidumping provisions in the Act because of its
concern with an increasing number of reports that hospital emergency
rooms were refusing to accept or treat individuals with emergency
conditions if the individuals did not have insurance.
I. Description of the New System of Records
A. Statutory and Regulatory Basis for System
The authority to conduct the program is given under the provisions
of Section 1011 of the Medicare Prescription Drug, Improvement and
Modernization Act of 2003 (Pub. L. 108-173).
B. Collection and Maintenance of Data in the System
The Section 1011 program includes the provider name and
identification number, provider address, provider employer
identification number, provider banking information, provider federal
tax identification number, patient's control number, medical record
number, date of service, patient's gender, zip code, state and county,
the principle diagnosis code, admitting diagnosis code, and total
charges. It also includes claims information related to Section 1011
payment requests, and other research information needed to pay claims
and administer the Section 1011 program.
II. Agency Policies, Procedures, and Restrictions on the Routine
The Privacy Act permits us to disclose information without an
individual's consent if the information is to be used for a purpose
that is compatible with the purpose(s) for which the information was
collected. Any such disclosure of data is known as a ``routine use.''
The government will only release Section 1011 program information that
can be associated with an individual provider as provided for under
``Section III. Entities Who May Receive Disclosures under Routine
Use.'' Both identifiable and non-identifiable data may be disclosed
under a routine use. Identifiable data includes individual records with
Section 1011 program information and identifiers. Non-identifiable data
includes individual records with Section 1011 program information and
masked identifiers or Section 1011 program information with identifiers
stripped out of the file.
We will only disclose the minimum personal data necessary to
achieve the purpose of the Section 1011 program. CMS has the following
policies and procedures concerning disclosures of information that will
be maintained in the system. In general, disclosure of information from
the system will be approved only for the minimum information necessary
to accomplish the purpose of the disclosure after CMS:
1. Determines that the use or disclosure is consistent with the
reason that the data is being collected; e.g., to maintain information
needed when submitting an enrollment application and make payment
requests associated with Section 1011(a) of the MMA;.
2. Determines that:
a. The purpose for which the disclosure is to be made can only be
accomplished if
b. The record is provided in individually identifiable form;
c. The purpose for which the disclosure is to be made is of
sufficient importance to warrant the effect and/or risk on the privacy
of the individual that additional exposure of the record might bring;
and
d. There is a strong probability that the proposed use of the data
would in fact accomplish the stated purpose(s).
3. Requires the information recipient to:
a. Establish administrative, technical, and physical safeguards to
prevent unauthorized use of disclosure of the record;
b. Remove or destroy at the earliest time all patient-identifiable
information; and
c. Agree to not use or disclose the information for any purpose
other than the stated purpose under which the information was
disclosed.
4. Determines that the data are valid and reliable.
III. Proposed Routine Use Disclosures of Data in the System
A. Entities Who May Receive Disclosures Under Routine Use
These routine uses specify circumstances, in addition to those
provided by statute in the Privacy Act of 1974, under which CMS may
release information from the Section 1011 program without the consent
of the individual to whom such information pertains. Each proposed
disclosure of information under these routine uses will be evaluated to
ensure that the disclosure is legally permissible, including but not
limited to ensuring that the purpose of the disclosure is compatible
with the purpose for which the information was collected. We are
proposing to establish the following routine use disclosures of
information maintained in the system:
1. To agency contractors or consultants who have been contracted by
the agency to assist in the performance of a service related to this
system and who need to have access to the records in order to perform
the activity.
We contemplate disclosing information under this routine use only
in situations in which CMS may enter into a contractual or similar
agreement with a third party to assist in accomplishing agency business
functions relating to purposes for this system of records.
CMS occasionally contracts out certain of its functions when doing
so would contribute to effective and efficient operations. CMS must be
able to give a contractor whatever information is necessary for the
[[Page 45399]]
contractor to fulfill its duties. In these situations, safeguards are
provided in the contract prohibiting the contractor from using or
disclosing the information for any purpose other than that described in
the contract and requires the contractor to return or destroy all
information at the completion of the contract.
2. To a CMS contractor that assists in the administration of a CMS-
administered health benefits program, when disclosure is deemed
reasonably necessary by CMS to prevent, deter, discover, detect,
investigate, examine, prosecute, sue with respect to, defend against,
correct, remedy, or otherwise combat fraud or abuse in such program.
We contemplate disclosing information under this routine use only
in situations in which CMS may enter into a contractual relationship or
grant with a third party to assist in accomplishing CMS functions
relating to the purpose of combating fraud and abuse.
CMS occasionally contracts out certain of its functions and makes
grants when doing so would contribute to effective and efficient
operations. CMS must be able to give a contractor or grantee whatever
information is necessary for the contractor or grantee to fulfill its
duties. In these situations, safeguards are provided in the contract
prohibiting the contractor or grantee from using or disclosing the
information for any purpose other than that described in the contract
and requiring the contractor or grantee to return or destroy all
information.
3. To another Federal agency or to an instrumentality of any
governmental jurisdiction within or under the control of the United
States (including any State or local governmental agency), that
administers, or that has the authority to investigate potential fraud
or abuse in, a health benefits program funded in whole or in part by
Federal funds, when disclosure is deemed reasonably necessary by CMS to
prevent, deter, discover, detect, investigate, examine, prosecute, sue
with respect to, defend against, correct, remedy, or otherwise combat
fraud or abuse in such programs.
Other agencies may require Section 1011 program information for the
purpose of combating fraud and abuse in such Federally-funded programs.
Releases of information would be allowed if the proposed use(s) for the
information proved compatible with the purposes of collecting the
information.
4. To another Federal or state agency to:
a. Contribute to the accuracy of CMS'' proper payment of a health
benefit, or
b. Enable such agency to administer a Federal health benefits
program, or as necessary to enable such agency to fulfill a requirement
of a Federal statute or regulation that implements a health benefits
program funded in whole or in part with Federal funds.
Other Federal or state agencies in their administration of a
Federal health program may require Section 1011 program information in
order to ensure that proper payment for services were provided.
Releases of information would be allowed if the proposed use(s) for the
information proved compatible with the purpose for which CMS collects
the information.
5. To a Member of Congress or to a congressional staff member in
response to an inquiry of the Congressional Office made at the written
request of the constituent about whom the record is maintained.
Individuals sometimes request the help of a Member of Congress in
resolving some issue relating to a matter before CMS. The Member of
Congress then writes CMS, and CMS must be able to give sufficient
information to be responsive to the inquiry.
6. To the Department of Justice (DOJ), court or adjudicatory body
when:
a. The agency or any component thereof, or
b. Any employee of the agency in his or her official capacity; or
c. Any employee of the agency in his or her individual capacity
where the DOJ has agreed to represent the employee, or
d. The United States Government;
Is a party to litigation or has an interest in such litigation, and
by careful review, CMS determines that the records are both relevant
and necessary to the litigation.
Whenever CMS is involved in litigation, or occasionally when
another party is involved in litigation and CMS' policies or operations
could be affected by the outcome of the litigation, CMS would be able
to disclose information to the DOJ, court or adjudicatory body
involved. A determination would be made in each instance that, under
the circumstances involved, the purposes served by the use of the
information in the particular litigation is compatible with a purpose
for which CMS collects the information.
B. Additional Provisions Affecting Routine Use Disclosures
This system contains Protected Health Information (PHI) as defined
by HHS regulation ``Standards for Privacy of Individually Identifiable
Health Information'' (45 CFR parts 160 and 164, 65 FR 82462 (12-28-00),
Subparts A and E. Disclosures of PHI authorized by these routine uses
may only be made if, and as, permitted or required by the ``Standards
for Privacy of Individually Identifiable Health Information.''
In addition, our policy will be to prohibit release even of not
directly identifiable, except pursuant to one of the routine uses or if
required by law, if we determine there is a possibility that an
individual can be identified through implicit deduction based on small
cell sizes (instances where the patient population is so small that
individuals who are familiar with the enrollees could, because of the
small size, use this information to deduce the identity of the
beneficiary).
IV. Safeguards
CMS has safeguards in place for authorized users and monitors such
users to ensure against excessive or unauthorized use. Personnel having
access to the system have been trained in the Privacy Act and
information security requirements. Employees who maintain records in
this system are instructed not to release data until the intended
recipient agrees to implement appropriate management, operational and
technical safeguards sufficient to protect the confidentiality,
integrity and availability of the information and information systems
and to prevent unauthorized access.
This system will conform to all applicable Federal laws and
regulations and Federal, HHS, and CMS policies and standards as they
relate to information security and data privacy. These laws and
regulations include but are not limited to: the Privacy Act of 1974;
the Federal Information Security Management Act of 2002; the Computer
Fraud and Abuse Act of 1986; the Health Insurance Portability and
Accountability Act of 1996; the E-Government Act of 2002, the Clinger-
Cohen Act of 1996; the Medicare Modernization Act of 2003, and the
corresponding implementing regulations. OMB Circular A-130, Management
of Federal Resources, Appendix III, Security of Federal Automated
Information Resources also applies. Federal, HHS, and CMS policies and
standards include but are not limited to: All pertinent NIST
publications; the HHS Information Systems Program Handbook and the CMS
Information Security Handbook.
V. Effects of the New System on Individual Rights
CMS proposes to establish this system in accordance with the
principles and requirements of the Privacy Act and will collect, use,
and disseminate
[[Page 45400]]
information only as prescribed therein. Data in this system will be
subject to the authorized releases in accordance with the routine uses
identified in this system of records.
CMS will monitor the collection and reporting of Section 1011 data.
Section 1011 information on patients is submitted to CMS in a standard
payment system. Accuracy of the data is important since incorrect
information could result in the wrong payment for services. CMS will
utilize a variety of onsite and offsite edits and audits to increase
the accuracy of Section 1011 payment requests.
CMS will take precautionary measures (see item IV. above) to
minimize the risks of unauthorized access to the records and the
potential harm to individual privacy or other personal or property
rights of patients whose data is maintained in the system. CMS will
collect only that information necessary to perform the system's
functions. In addition, CMS will make disclosure from the proposed
system only with consent of the subject individual, or his/her legal
representative, or in accordance with an applicable exception provision
of the Privacy Act.
CMS, therefore, does not anticipate an unfavorable effect on
individual privacy as a result of maintaining this system of records.
Charlene Brown,
Chief Operating Officer, Centers for Medicare & Medicaid Services.
SYSTEM NO. 09-70-0546
SYSTEM NAME:
``Federal Reimbursement of Emergency Health Services Furnished to
Undocumented Aliens (Section 1011)'' HHS/CMS/CMM.
SECURITY CLASSIFICATION:
Level 3, Privacy Act Sensitive.
SYSTEM LOCATION:
CMS Data Center, 7500 Security Boulevard, North Building, First
Floor, Baltimore, Maryland 21244-1850 and CMS contractors and agents at
various locations.
CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
The Section 1011 program will include information on individuals
who have elected to participate in the Section 1011 program, claims
information related to Section 1011 payment requests, and information
needed to pay claims and administer the Section 1011 program.
CATEGORIES OF RECORDS IN THE SYSTEM:
The Section 1011 program includes the provider name and
identification number, provider address, provider employer
identification number, provider banking information, provider Federal
tax identification number, patient's control number, medical record
number, date of service, patient's gender, zip code, state and county,
the principle diagnosis code, admitting diagnosis code, and total
charges. It also includes claims information related to Section 1011
payment requests, and other research information needed to pay claims
and administer the Section 1011 program.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
The authority to conduct the program is given under the provisions
of Section 1011 of the Medicare Prescription Drug, Improvement and
Modernization Act of 2003 (Pub. L. 108-173).
PURPOSE (S) OF THE SYSTEM:
The primary purpose of the system is to maintain information
collected on individuals who submit an enrollment application and make
payment requests associated with Section 1011 of the MMA, and other
information designed to support the enrollment, claims payment, and
research reporting functions of the Section 1011 program. Information
retrieved from this system will also be disclosed to: (1) Support
regulatory, payment activities, and policy functions performed within
the agency or by a designated contractor or consultant; (2) combat
fraud and abuse in certain health benefits programs; (3) assist another
Federal or state agency with information to enable such agency to
administer a Federal health benefits program, or to enable such agency
to fulfill a requirement of a Federal statute or regulation that
implements a health benefits program funded in whole or in part with
Federal; (4) funds support constituent requests made to a Congressional
representative; and, (5) support litigation involving the agency.
ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES
OR USERS AND THE PURPOSES OF SUCH USES:
A. Entities Who May Receive Disclosures Under Routine Use
These routine uses specify circumstances, in addition to those
provided by statute in the Privacy Act of 1974, under which CMS may
release information from the Section 1011 program without the consent
of the individual to whom such information pertains. Each proposed
disclosure of information under these routine uses will be evaluated to
ensure that the disclosure is legally permissible, including but not
limited to ensuring that the purpose of the disclosure is compatible
with the purpose for which the information was collected. We are
proposing to establish the following routine use disclosures of
information maintained in the system:
1. To agency contractors or consultants who have been contracted by
the agency to assist in the performance of a service related to this
system and who need to have access to the records in order to perform
the activity.
2. To a CMS contractor that assists in the administration of a CMS-
administered health benefits program, or to a grantee of a CMS-
administered grant program, when disclosure is deemed reasonably
necessary by CMS to prevent, deter, discover, detect, investigate,
examine, prosecute, sue with respect to, defend against, correct,
remedy, or otherwise combat fraud or abuse in such program.
3. To another Federal agency or to an instrumentality of any
governmental jurisdiction within or under the control of the United
States (including any State or local governmental agency), that
administers, or that has the authority to investigate potential fraud
or abuse in, a health benefits program funded in whole or in part by
Federal funds, when disclosure is deemed reasonably necessary by CMS to
prevent, deter, discover, detect, investigate, examine, prosecute, sue
with respect to, defend against, correct, remedy, or otherwise combat
fraud or abuse in such programs.
4. To another Federal or State agency to:
a. Contribute to the accuracy of CMS' proper payment of a health
benefit, or
b. Enable such agency to administer a Federal health benefits
program, or as necessary to enable such agency to fulfill a requirement
of a Federal statute or regulation that implements a health benefits
program funded in whole or in part with Federal funds.
5. To a Member of Congress or to a congressional staff member in
response to an inquiry of the Congressional Office made at the written
request of the constituent about whom the record is maintained.
6. To the Department of Justice (DOJ), court or adjudicatory body
when:
a. The agency or any component thereof, or
b. Any employee of the agency in his or her official capacity; or
c. Any employee of the agency in his or her individual capacity
where the DOJ has agreed to represent the employee, or
d. The United States Government;
[[Page 45401]]
Is a party to litigation or has an interest in such litigation, and
by careful review, CMS determines that the records are both relevant
and necessary to the litigation.
B. Additional Provisions Affecting Routine Use Disclosures
This system contains Protected Health Information (PHI) as defined
by HHS regulation ``Standards for Privacy of Individually Identifiable
Health Information'' (45 CFR parts 160 and 164, 65 FR 82462 (12-28-00),
Subparts A and E. Disclosures of PHI authorized by these routine uses
may only be made if, and as, permitted or required by the ``Standards
for Privacy of Individually Identifiable Health Information.''
In addition, our policy will be to prohibit release even of not
directly identifiable, except pursuant to one of the routine uses or if
required by law, if we determine there is a possibility that an
individual can be identified through implicit deduction based on small
cell sizes (instances where the patient population is so small that
individuals who are familiar with the enrollees could, because of the
small size, use this information to deduce the identity of the
beneficiary).
POLICIES AND PRACTICES FOR STORING, RETRIEVING, ACCESSING, RETAINING,
AND DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
All claim records are stored on magnetic media. Patient eligibility
information may be maintained electronically or in paper format.
RETRIEVABILITY:
Providers will retrieve medical records by the patient control
number. Provider IDs and patient control numbers are used to facilitate
inquiries into specific claims as needed.
SAFEGUARDS:
CMS has safeguards in place for authorized users and monitors such
users to ensure against excessive or unauthorized use. Personnel having
access to the system have been trained in the Privacy Act and
information security requirements. Employees who maintain records in
this system are instructed not to release data until the intended
recipient agrees to implement appropriate management, operational and
technical safeguards sufficient to protect the confidentiality,
integrity and availability of the information and information systems
and to prevent unauthorized access.
This system will conform to all applicable Federal laws and
regulations and Federal, HHS, and CMS policies and standards as they
relate to information security and data privacy. These laws and
regulations include but are not limited to: The Privacy Act of 1974;
the Federal Information Security Management Act of 2002; the Computer
Fraud and Abuse Act of 1986; the Health Insurance Portability and
Accountability Act of 1996; the E-Government Act of 2002, the Clinger-
Cohen Act of 1996; the Medicare Modernization Act of 2003, and the
corresponding implementing regulations. OMB Circular A-130, Management
of Federal Resources, Appendix III, Security of Federal Automated
Information Resources also applies. Federal, HHS, and CMS policies and
standards include but are not limited to: All pertinent NIST
publications; the HHS Automated Information Systems Security Handbook
and the CMS Information Security Handbook.
RETENTION AND DISPOSAL:
CMS will retain identifiable Section 1011 data for an indefinite
period. Data residing with the designated claims payment contractor
shall be returned to CMS at the end of the fifth program year, with all
data then being the responsibility of CMS for adequate storage and
security.
SYSTEM MANAGER AND ADDRESS:
Section 1011 Project Officer, Center for Medicare Management, CMS,
7500 Security Boulevard, Mail Stop C4-10-07, Baltimore, Maryland,
21244-1850.
NOTIFICATION PROCEDURE:
For purpose of access, the subject individual should write to the
system manager who will require the system name, and for verification
purposes, the subject individual's name and provider identification
number and the patient's medical record number.
RECORD ACCESS PROCEDURE:
For purpose of access, use the same procedures outlined in
Notification Procedures above. Requestors should also reasonably
specify the record contents being sought. (These procedures are in
accordance with Department regulation 45 CFR 5b.5(a)(2).)
CONTESTING RECORD PROCEDURES:
The subject individual should contact the system manager named
above, and reasonably identify the record and specify the information
to be contested. State the corrective action sought and the reasons for
the correction with supporting justification. (These procedures are in
accordance with Department regulation 45 CFR 5b.7.)
RECORD SOURCE CATEGORIES:
Information maintained in this system will be collected from
individuals volunteering to participate in Section 1011 program through
the enrollment application and claims data requesting payment for
services.
SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS OF THE ACT:
None.
[FR Doc. 05-15165 Filed 8-4-05; 8:45 am]
BILLING CODE 4120-03-P